Suture anchor with insert-molded rigid member

ABSTRACT

A threaded suture anchor with an eyelet shield transversely molded at a distal end of the anchor body, over which one or more strands of suture is looped. The anchor body is threaded and has a tapered distal portion. The proximal end portion of the suture anchor body has a opening to accept a drive head. The peripheral surface defining opening is rounded and smooth to prevent abrading sutures placed in contact therewith. In another embodiment, a push-in anchor is provided with an eyelet shield at the proximal end of the anchor.

This application is a continuation of U.S. application Ser. No.14/469,733 filed on Aug. 27, 2014, which is a continuation of U.S.application Ser. No. 11/518,872, filed on Sep. 12, 2006, now U.S. Pat.No. 8,821,541, which is a continuation-in-part of U.S. application Ser.No. 11/097,172, filed on Apr. 4, 2005, now U.S. Pat. No. 8,343,186. U.S.application Ser. No. 11/518,872 is also a continuation-in-part of U.S.application Ser. No. 10/083,568, filed on Feb. 27, 2002, now U.S. Pat.No. 7,226,469, which claims priority to U.S. Provisional Application No.60/271,414, filed on Feb. 27, 2001, and which is a continuation-in-partof U.S. application Ser. No. 09/495,816, filed on Feb. 2, 2000, now U.S.Pat. No. 6,517,564, which claims priority to U.S. ProvisionalApplication No. 60/118,228, filed on Feb. 2, 1999 and U.S. ProvisionalApplication No. 60/125,781, filed on Mar. 23, 1999. U.S. applicationSer. No. 11/518,872 is also a continuation-in-part of U.S. applicationSer. No. 11/224,060, filed on Sep. 13, 2005. U.S. application Ser. No.11/518,872 also claims priority to U.S. Provisional Application No.60/715,614, filed on Sep. 12, 2005. The disclosures of all of theabove-cited applications are incorporated by reference in theirentirety.

FIELD OF THE INVENTION

The present invention relates to an apparatus for anchoring surgicalsuture to bone, and more particularly, to an apparatus using a sutureanchor having a transverse anchor pin or an insert-molded eyelet shield.

BACKGROUND OF THE INVENTION

When soft tissue tears away from bone, reattachment becomes necessary.Various devices, including sutures alone, screws, staples, wedges, andplugs have been used in the prior art to secure soft tissue to bone.

Recently, various types of threaded suture anchors have been developedfor this purpose. Some threaded suture anchors are designed to beinserted into a pre-drilled hole. Other suture anchors are self-tapping.

U.S. Pat. No. 4,632,100 discloses a cylindrical threaded suture anchor.The suture anchor of the '100 patent includes a drill bit at a leadingend for boring a hole in a bone, followed by a flight of threads spacedfrom the drill bit for securing the anchor into the hole created by thedrill bit.

U.S. Pat. No. 5,370,662 discloses a suture anchor having threads whichextend to the tip of the anchor. U.S. Pat. No. 5,156,616 discloses asimilar suture anchor having an axial opening for holding a knottedpiece of suture.

All of the above-noted suture anchors include a structure for attachingthe suture to the anchor. U.S. Pat. No. 4,632,100, for example,discloses a press-fitted disc and knot structure which secures thesuture to the anchor. In other suture anchors, such as those disclosedin U.S. Pat. No. 5,370,662, the suture is passed through an eyeletlocated on the proximal end of the anchor. In the case of abioabsorbable suture anchor, the suture may be insert molded into theanchor, as disclosed in U.S. Pat. No. 5,964,783.

Problems can arise if the structure for attaching the suture fails,allowing the suture to become detached from the anchor. Also, the sutureoften is exposed to abrasion or cutting by sharp or rough areas alongthe walls of the bone canal into which the anchor is inserted.

Moreover, the eyelet or, in the case of U.S. Pat. No. 4,632,100, theaxial opening for receiving the disc to which the suture is knotted, isformed as part of the drive head of the known suture anchors. Combiningthese two functions in one structure often tends to weaken the drivehead.

In addition, various other modifications to the drive head often areemployed in connection with suture attachment. For example, recessedgrooves may be formed on opposite sides of the drive head to receive andprotect the suture from abrasive areas of the suture anchor tunnel or tofacilitate mating between the anchor to the driver. In such cases, thedrive head often must be made of a larger diameter to recover themechanical strength lost from the removal of material relating to thesuture-attachment or suture-protection modifications.

Further, the prior art suture anchors having eyelets extending from theproximal ends require countersinking of the eyelet below the bonesurface to avoid having the patient's tissue abrade against the exposedeyelet. As a result, suture attached to the eyelet is vulnerable toabrasion by the bony rim of the countersunk hole into which the sutureanchor is installed. In addition, in biodegradable suture anchors, thesuture eyelet can degrade rapidly, causing the suture to become detachedfrom the anchor prematurely.

Accordingly, there is a need for a threaded suture anchor to whichsuture is secured effectively so as to prevent detachment of the suture.It is further desirable for such suture anchors to have eyelets thatwill not abrade tissue and which do not require countersinking.

Further, there is a need for a suture eyelet shield within abiodegradable suture anchor with a bearing surface that will resistsuture cut-through of the bioabsorbable material.

SUMMARY OF THE INVENTION

The suture anchor of the present invention overcomes the disadvantagesof the prior art discussed above by providing, in one embodiment, afully threaded suture anchor with an eyelet shield that is molded intothe distal part of the biodegradable suture anchor. The eyelet shield ofthe present invention provides the strength necessary to secure thesuture and also prevents suture cut-through.

The eyelet formed at the distal end is formed of a piece of suture orother material transversely insert-molded into the anchor so as toprovide an eyelet shield. The shield provides a bearing surface thatwill resist suture cut-through.

In accordance with another embodiment of the invention, a ribbed sutureanchor is provided with an eyelet shield at the proximal end. The eyeletshield is formed of a loop of suture material which is inserted moldedwithin the suture anchor during the manufacturing process.

Other features and advantages of the present invention will becomeapparent from the following description of the invention, which refersto the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a side elevational view of the suture anchor according to anembodiment of the invention.

FIG. 2 is a longitudinal sectional view of the suture anchor shown inFIG. 1 through the plane D-D indicated therein.

FIG. 3 is a proximal end view of the suture anchor of FIG. 1.

FIG. 4A is a cross sectional view of the suture anchor of FIG. 1 showinga suture looped over the transverse anchor pin.

FIG. 4B is a cross sectional view of the suture anchor of FIG. 1 showinga portion of a polygonal driver inserted into a polygonally shaped boreof the suture anchor.

FIG. 4C is a cross sectional view of the suture anchor of FIG. 1 showingthe polygonal driver inserted into a polygonally shaped bore of thesuture anchor.

FIG. 5 is a perspective representation of the suture anchor according toanother embodiment of the invention.

FIG. 6 is an end view of the suture anchor shown in FIG. 5.

FIG. 7A is an elevational cross-section of the suture anchor of FIG. 6through the plane B-B indicated therein.

FIG. 7B is an elevational cross-section of the suture anchor of FIG. 6through the plane B-B indicated therein showing a portion of a driverinserted into a bore of a suture anchor.

FIG. 8 is a cross-section in plan view of the suture anchor of FIG. 6through the plane C-C indicated therein.

FIG. 9 is a plan view of the push-in suture anchor according to anotherembodiment of the invention.

FIG. 10 is a plan view of the push-in suture anchor of FIG. 9 showing asuture insert-molded within the suture anchor.

FIG. 11 is a proximal end view of the suture anchor of FIG. 9.

FIG. 12 is a longitudinal sectional view of the suture anchor shown inFIG. 9 through the plane A-A, indicated therein.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

In the following detailed description, reference is made to variousspecific embodiments in which the invention may be practiced. Theseembodiments are described with sufficient detail to enable those skilledin the art to practice the invention, and it is to be understood thatother embodiments may be employed, and that structural and logicalchanges may be made without departing from the spirit or scope of thepresent invention.

FIG. 1 illustrates a suture anchor according to a first preferredembodiment of the present invention, indicated generally by referencenumeral 110. In the preferred embodiment, body 108 of anchor 110generally tapers to a narrow point 114 at the distal end thereof. Inparticular, the major diameter of the anchor body is generally constantalong about two-thirds of the length of the body, whereupon the diameterof the anchor then tapers to a relatively sharp point, e.g.,approximately 16°. The relatively sharp distal tip of anchor 110 enablesthe anchor to be installed without having to first drill a hole in thebone where the anchor 110 is to be installed.

Although such tapering is preferred, suture anchor 110 may be formed tohave a less tapered shape, or even cylindrical shape, to accommodatedifferent preferences of the surgeon and/or the application of thesuture anchor. For example, the tapered distal end of the anchor may beformed to be more blunt, in which case it is necessary to provide apre-formed hole in the bone prior to insertion of the suture anchor.

A continuous thread 116 wraps around the body 108 in a clockwisedirection, as shown. Anchor 110 has about five flights of thread, withthe angle of the threads and other configurations of the anchor beingsimilar to the suture anchor of U.S. Pat. No. 6,511,499, the disclosureof which is hereby incorporated by reference in its entirety.

As can be seen more clearly with reference to FIG. 3, the proximal endportion of the anchor has a polygonally shaped bore 134, preferablyhexagonal or square, having an opening 112 at the proximal end 92 ofanchor body 108 and extending into the anchor body approximatelyone-third of the length thereof. Prior art anchors have sharp edgesaround the drive opening, which is problematic in that sutures passingthrough the central opening at the proximal end 92 of the anchor can beabraded by the sharp edges, thereby compromising the strength of thesutures. In the suture anchor of the present invention, the peripheraledges defining polygonally shaped opening 112 is smooth and roundedoutwardly with no sharp edges. Preferably, the opening 112 forms aslight lip curving around the diameter of the bore 134. Thus, suturesthreaded through the anchor 110, as will be discussed below, will notbecome frayed upon being pressed or rubbed against the anchor at theproximal opening 112.

As shown in FIG. 2, a cylindrical bore 136 having a diametercorresponding to that of the polygonally shaped bore 134 extends fromthe distal end of the polygonally shaped bore 134 to a position roughlyhalfway along the length of anchor body 108. The transition betweenpolygonally shaped bore 134 and cylindrical bore 136 forms an annularshoulder 140, against which the distal end of a polygonal driver 202,preferably hexagonal or square, abuts when inserted into the polygonallyshaped bore 134 to drive the anchor into bone.

Two longitudinal, diametrically opposite apertures 118 are formed inanchor body 108, the apertures 118 supporting a metal transverse anchorpin 120 which extends across cylindrical bore 136.

As illustrated in FIGS. 1, 2 and 4 a, apertures 118 extend through andinterrupt the threads 116 around anchor body 108 at approximatelyone-third of the length of the anchor body from the proximal end 92thereof. One or more sutures 200 are secured to the anchor by loopingthe suture(s) around metal anchor pin 120 as shown in FIG. 4a . Althoughthe metal anchor pin 120 is illustrated in FIGS. 2 and 4 a as orientedtransversal to longitudinal axis 150 of the anchor body 108, the metalanchor pin 120 may form any angle with the longitudinal axis 150 and,thus, the invention is not limited to metal anchor pin 120 forming anangle of about ninety degrees with the longitudinal axis 150 of theanchor body 108.

Preferably, suture anchor 110 is formed of a hard biocompatible metal,such as a titanium alloy, but can be made of biocompatible materialsother than metal. The suture secured to the anchor may be FiberWiresuture, sold by Arthrex, Inc. of Naples, Fla.

The suture anchor according to the present invention need not be formedas a threaded device, but can also be formed as a tap-in type anchor.Also, the measurements, angles and ratios between the dimensions of thesuture anchor may be varied from those described above so as to besuitable for the conditions and applications in which the suture anchoris to be used.

In manufacturing the suture anchor 110 in accordance with the presentinvention, the anchor body 108 is cast in a die, with the bores,passageways and apertures described above either being formed during thecasting process or formed afterwards. If necessary, the distal tip 114of the anchor 110 is trimmed to the desired length and the surfaces ofthe anchor are polished to the desired finish.

As mentioned above, the suture anchor 110 of the present invention maybe installed in the bone without the need to pre-drill a hole in thebone. The suture anchor 110 is installed using a driver 202 having ashaft having a polygonal cross-section for at least a length equal tothe length of the polygonal bore 134 from proximal opening 112 to theshoulder 140 inside the anchor 110. The driver 202 has a cannula 204extending through the entire length thereof, with openings 216 and 214at the proximal end and the distal end, respectively, thereof. Ofcourse, the outer diameter of the polygonal shaft is sized to fit insidethe polygonal bore in the anchor so as to be enabled to drive the same.

As shown in FIGS. 4b and 4c , with the desired number of suture strands200 threaded around the anchor pin 120 in the suture anchor 110, theends 206 and 208 of the suture strands 200 are threaded through thecannula 204 in the polygonal driver 202 from the distal end thereof andextend from the proximal opening 216 thereof. The distal end of thepolygonal driver 202 is inserted into the proximal end 92 of the anchor110. With the distal end of the driver 202 abutting the shoulder 140 andthe anchor 110 positioned at the location at which it is to beinstalled, the polygonal driver 202 is rotated to drive the anchor 110into the bone until the proximal surface of the anchor 110 is flush withthe surface of the bone.

Since it is not necessary for the proximal end 92 of the anchor to becountersunk below the bone surface to prevent tissue abrasion by anexposed suture loop, as is required with prior art devices, the sutureanchor of the present invention does not need to be inserted as far asthe prior art anchors, while also avoiding abrasion of the sutures bythe rim of the bone.

The suture anchor of the present invention provides greater pull-outstrength of the suture loop than prior suture anchors. In addition, thesuture loop of the present invention, being disposed inside the sutureanchor, is protected from abrasion and degradation.

Referring to FIG. 5, a suture anchor 1 is shown in perspective inaccordance with another embodiment of the invention. In this embodiment,the suture anchor 1 has a fully-threaded body 3. The suture anchor 1includes a proximal end 92, a distal end 60, an exterior surface 62, aninternal bore 15, a length 64, and a longitudinal axis 66. An externalhelical thread 68 on the exterior surface 62 extends from the proximalend 92 to a location distal of the eyelet shield 9. A wall 70 is definedby the external helical thread 68 and a surface 72 of the internal bore15. The internal bore 15 extends along the longitudinal axis 66 from theopening 111 through a portion of the length 64 of the suture anchor 1.The suture anchor 1 may be comprised of any material. Preferably, thesuture anchor 1 is formed of a bioabsorbable material. Rather thanhaving an anchor pin as discussed in the embodiment above, the sutureanchor 1 has an eyelet shield 9 of the same material that is integrallymolded transversely into a distal part 11 of the threaded body 3 of thesuture anchor 1 and located in the distal half of the suture anchor 1.The external helical thread 68 ends in the distal half of the sutureanchor 1. The eyelet shield 9 is shown as a bar, however, anyappropriate type of material may be used, including bioabsorbablematerial or a length of suture, for example. The eyelet shield 9 caninclude of a length of suture 90 molded transversely into the distalpart 11 of the threaded body 3. The eyelet suture 9 includes a first endportion and an opposing second end portion, and both the first endportion and the second end portion are integral with the threaded body3. Although the eyelet shield 9 is illustrated as being transverse tothe longitudinal axis of suture anchor 1, the eyelet shield 9 may alsobe formed at any angle with respect to the longitudinal axis and, thus,the invention is not limited to the eyelet shield 9 formed an angle ofabout ninety degrees with the longitudinal axis of the suture anchor 1.

As illustrated in FIGS. 6-8, two strands of tie-down sutures 5, 7 arethreaded around a leading distal surface 74 of the eyelet shield 9 ofthe distal part 11 of the suture anchor 1 and threaded into an internalsuture passage 94. In one example, a suture passage 94 is on opposingsides of the eyelet shield 9 and located between the eyelet shield 9 andthe wall 70. The suture passage 94 interrupts the external helicalthread 68. The portion of the suture 5, 7 disposed in the internal bore15 is surrounded by the external helical thread 68 of the suture anchor1. Another opening 76 is defined through the exterior surface 62 of thesuture anchor 1 and distal of the eyelet shield 9 of the suture anchor1. The sutures 5, 7 are disposed in the opening 111, the internal suturepassage 94, and the another opening 76. The suture passage 94 is distalto the opening 111, and the another opening 76 is distal of the suturepassage 94. The eyelet shield 9 provides a bearing surface around whichsutures 5, 7 are threaded and disposed. The eyelet shield 9 extendsacross the longitudinal axis 66 and is attached to the surface 72 of theinternal bore 15 at an axially fixed longitudinal position. The sutures5, 7 threaded through the internal bore 15 and disposed about the eyeletshield 9 have tails 78 and 80 which each have ends 306 and 308,respectively, that extend out the opening 111 of the proximal end 92 ofthe suture anchor 1. The internal bore 15 extends from the proximal end92 of the suture anchor 1 to a location roughly halfway along the sutureanchor 1. As discussed above, the internal bore 15 has the opening 111at the proximal end 92 of the suture anchor 1 and is shaped toaccommodate a driver head for driving the suture anchor 1.

As shown in FIG. 7a , the internal bore 15 has a first internal planarsurface 82 and an opposing second internal planar surface 84 that areboth parallel to the longitudinal axis 66 and made of the same materialas the eyelet shield 9. The first tail 78 is located in a first space 86defined between the eyelet shield 9 and the first internal planarsurface 82, and the second tail 80 is located in a second space 88defined between the eyelet shield 9 and the second internal planarsurface 84. As shown in FIG. 7b , the suture 5, 7 is slidable andfollows a path beginning with the first end 306 of the first tail 78 ofthe suture 5, 7 outside the suture anchor 1, into the first space 86 ofthe internal bore 15, around the eyelet shield 9, back through thesecond space 88 of the internal bore 15, and ending at the second end308 of the second tail 80 of the suture 5, 7 outside of the sutureanchor 1.

The eyelet shield 9 resists suture cut. Further, the eyelet shield 9provides the strength necessary to secure the sutures 5, 7. In addition,because the eyelet shield 9 is molded transversely into the distal endof the suture anchor 1, this provides greater security to preventpull-out of the suture from within the suture anchor 1 or from an anchorpin, which could loosen. The eyelet shield 9 also prevents the suturefrom fraying.

Although a fully-threaded suture anchor 1 with threaded body 3 is shown,the anchor does not necessarily have to be fully threaded. As discussedabove, the suture anchor also need not be a threaded device, but canalso be formed as a tap-in type anchor. In addition, sutures 5, 7 can beinsert-molded into the anchor to prevent saw-through.

As shown in FIG. 7b , the suture anchor 1 is installed using a driver300. The driver 300 has a cannula 302 with openings 310 and 312 at theproximal and distal, respectively, ends thereof. When the driver 300 isreceived in the internal bore 15 of the suture anchor 1, a first planardriver face 96 is engageable with the first planar passage face 82, anda second planar driver face 98 is engageable with the second planarpassage face 84. As shown in FIGS. 7A and 7B, with the desired number ofsutures 5 and 7 threaded around the shield 9 in the suture anchor 1,ends 306 and 308 of the sutures 5 and 7 are threaded through the cannula302 in the driver 300 from a distal end 312 thereof and extend from theproximal opening 310 thereof. The distal end of the driver 300 isinserted into the proximal end 92 of the anchor 1, and the driver 300 isrotated to drive the anchor 1 into the bone until the proximal surfaceof the anchor 1 is flush with the surface of the bone. A suture lengthof the suture 5,7 (the length is shown in as a half length 102 in FIG.7b ) is greater than the shaft length 100 of the cannula 302.

In another embodiment, as illustrated in FIGS. 9-12, a push-in sutureanchor 20 is shown having suture 22 that is insert-molded longitudinallyinto the suture anchor body 24 during the manufacturing process.

The suture anchor body 24 preferably is formed of a bioabsorbablematerial, poly(1-lactide-co-d, 1-lactide) 70:30 (PLDLA) being mostpreferred. Suture 22 can be any known type of suture selected accordingto the size of the anchor and the anticipated application. The suture 22preferably is No. 2 polyester braided suture.

At least one length of the insert-molded suture 22 extends from theproximal end 92 of the suture anchor body 24. Preferably, the suture 22extends from the suture anchor body 24 in the form of a loop. The suture22 is insert-molded into the suture anchor body 24 and also into theloop or eyelet 26. Various devices provide a suture anchor with a loopformed of a suture material, as disclosed in U.S. Publication No.2002/0087190 and U.S. application Ser. No. 11/224,060, the entiredisclosures of which are incorporated by reference herein. However, thesuture loops disclosed in these applications are not encapsulated—thisresults in friction between the suture loop and a suture threadedthrough the loop. In the present invention, the suture 22, beinginsert-molded within the loop 26, eliminates suture against suturefriction and provides better support and strength for a suture threadedthrough the loop.

The distal end 28 of the suture anchor body 24 tapers to a blunt tip.Suture anchor 20 is provided with slotted ribs 30 formedcircumferentially at least partially around and partially along thelength of body 24. Ribs 30 have a truncated, conical anchor at an angleof preferably 15° with respect to the longitudinal axis of anchor 20,and reaching a major diameter of 3.0 mm.

Although PLDLA is the most preferred material for the suture anchor ofthe present invention, other bioabsorbable materials known in the artcan be utilized. As used herein, bioabsorbable is considered to beinterchangeable with biodegradable, resorbable, and absorbable to meanthat the device can be at least partially absorbed by the body overtime. Preferably, the anchor material is selected so as to absorb ordegrade substantially completely within 12-16 months of implantation.

Although the present invention has been described in relation toparticular embodiments thereof, many other variations and modificationsand other uses will become apparent to those skilled in the art.Therefore, the present invention is to be limited not by the specificdisclosure herein, but only by the appended claims.

The invention claimed is:
 1. A suture anchor assembly comprising: ananchor body including a longitudinal axis, an exterior surface, aproximal end, and a distal end, the anchor body including a firstopening at the proximal end of the anchor body, the anchor bodyincluding an internal passage extending along the longitudinal axis fromthe first opening through at least a portion of a length of the anchorbody, the anchor body including an external helical thread on theexterior surface, the external helical thread extending along the anchorbody, the anchor body including a second opening through the exteriorsurface of the anchor body, wherein the second opening is distal of thefirst opening, the anchor body including a third opening through theexterior surface of the anchor body and distal of a rigid support of theanchor body, wherein the third opening is distal of the second opening,the rigid support having a leading distal surface, wherein the rigidsupport extends across the longitudinal axis of the anchor body, a wallis defined by the external helical thread on the exterior surface of theanchor body and a surface of the internal passage, and the rigid supportis attached to the surface of the internal passage at an axially fixedlongitudinal position, wherein the external helical thread extends 360degrees around the longitudinal axis for at least a portion of thelength of the anchor body; and a suture strand extending out of thefirst opening of the anchor body, wherein a portion of the suture strandis disposed in the internal passage between the rigid support and thefirst opening, the suture strand is supported by the leading distalsurface of the rigid support, and the suture strand is disposed in thefirst opening, the second opening and the third opening of the anchorbody.
 2. The suture anchor assembly as recited in claim 1 wherein therigid support is integral with the anchor body to define a unitarysingle-piece component.
 3. The suture anchor assembly as recited inclaim 2 wherein the rigid support and the anchor body are made of thesame material.
 4. The suture anchor assembly as recited in claim 1wherein the second opening interrupts the external helical thread. 5.The suture anchor assembly as recited in claim 1 wherein the secondopening extends between the wall and the rigid support.
 6. The sutureanchor assembly as recited in claim 1 wherein the second opening isproximate to the rigid support.
 7. The suture anchor assembly as recitedin claim 1 wherein the external helical thread extends from the proximalend of the anchor body to a location distal of the rigid support.
 8. Thesuture anchor assembly as recited in claim 1 wherein the rigid supportis disposed in a distal half of the anchor body, and the distal half ofthe anchor body includes the distal end of the anchor body.
 9. Thesuture anchor assembly as recited in claim 1 wherein at least a portionof the internal passage is defined by a first planar passage face and asecond planar passage face that are both generally parallel to thelongitudinal axis of the anchor body.
 10. The suture anchor assembly asrecited in claim 9 including a driver having a first planar driver faceand a second planar driver face, the first planar driver face of thedriver engageable with the first planar passage face of the internalpassage and the second planar driver face of the driver engageable withthe second planar passage face of the internal passage when the driveris received in the internal passage of the anchor body.
 11. The sutureanchor assembly as recited in claim 10 wherein the driver has a cannula,the cannula has a distal opening and a proximal opening, the suturestrand includes a first tail and a second tail, the first tail of thesuture strand has a first end, the second tail of the suture strand hasa second end, and the first end and the second end of the suture strandextend out of the proximal opening of the cannula.
 12. The suture anchorassembly as recited in claim 10 wherein the driver includes a shafthaving a shaft length, the shaft is received in the internal passage ofthe anchor body, the suture strand has a suture length, and the suturelength of the suture strand is greater than the shaft length of theshaft.
 13. The suture anchor assembly as recited in claim 1 wherein theportion of the suture strand disposed in the internal passage issurrounded by the external helical thread of the anchor body.
 14. Thesuture anchor assembly as recited in claim 1 wherein the internalpassage has a first internal surface and a second internal surfacespaced opposite to the first internal surface, the suture strandincludes a first tail having a first end and a second tail having asecond end, a first space is defined between the rigid support and thefirst internal surface of the internal passage, a second space isdefined between the rigid support and the second internal surface of theinternal passage, the first tail is located in the first space, and thesecond tail is located in the second space.
 15. The suture anchorassembly as recited in claim 14 wherein the suture strand follows a pathbeginning with the first end of the first tail of the suture strandoutside the anchor body, into the first space of the internal passage,around the rigid support, back through the second space of the internalpassage, and ending at the second end of the second tail of the suturestrand outside of the anchor body.
 16. The suture anchor assembly asrecited in claim 1 wherein the suture strand includes a first tail and asecond tail, and each of the first tail and the second tail is slidablein two directions within the internal passage.
 17. The suture anchorassembly as recited in claim 1 wherein the rigid support includes afirst end portion and an opposing second end portion, and both the firstend portion and the second end portion are integral with the anchorbody.
 18. A suture anchor assembly comprising: an anchor body includinga longitudinal axis, a length extending along the longitudinal axis, aproximal end, a distal end, the anchor body including an internalcentral passage extending from a first opening at the proximal end ofthe anchor body, the internal central passage extending along thelongitudinal axis, and the internal central passage extending through atleast a portion of the length of the anchor body, the anchor bodyincluding an external helical thread extending along the anchor body ona wall of the anchor body, the anchor body including a second openingand a third opening, the second opening disposed distal of the firstopening, and the third opening disposed distal of the second opening anddistal of a rigid support, and the rigid support is disposed in a distalhalf of the anchor body, the distal half of the anchor body includingthe distal end of the anchor body, the second opening is proximate tothe rigid support, and the rigid support is attached to the wall,wherein the external helical thread extends 360 degrees around thelongitudinal axis for at least a portion of the length of the anchorbody; and a suture strand disposed in the internal central passage,wherein the suture strand is supported by the rigid support, the suturestrand extends out the proximal end of the anchor body, and the suturestrand is disposed in the first opening, the second opening and thethird opening of the anchor body.
 19. The suture anchor assembly asrecited in claim 18 wherein the rigid support is integral with theanchor body to define a unitary single-piece component.
 20. The sutureanchor assembly as recited in claim 19 wherein the rigid support and theanchor body are made of the same material.
 21. The suture anchorassembly as recited in claim 20 wherein the internal central passage hasa first internal surface and a second internal surface spaced oppositeto the first internal surface, the rigid support is secured to anddisposed between the first internal surface and the second internalsurface at an axially fixed longitudinal position, and the firstinternal surface and the second internal surface are made of the samematerial as the rigid support.
 22. The suture anchor assembly as recitedin claim 18 wherein the second opening is located between the rigidsupport and the external helical thread on the wall.
 23. The sutureanchor assembly as recited in claim 18 wherein the external helicalthread begins at the proximal end of the anchor body, ends in the distalhalf of the anchor body, and a portion of the suture strand disposed inthe internal central passage is surrounded by at least a portion of theexternal helical thread of the anchor body.
 24. The suture anchorassembly as recited in claim 18 including a driver having a cannula, thecannula having a distal opening and a proximal opening, the suturestrand including a first tail having a first end and a second tailhaving a second end, the first end and the second end extend out of theproximal opening of the cannula.
 25. The suture anchor assembly asrecited in claim 18 including a driver having a shaft with a shaftlength, the shaft is received in the internal central passage of theanchor body, the suture strand has a suture length, and the suturelength of the suture strand is greater than the shaft length of theshaft.
 26. The suture anchor assembly as recited in claim 18 wherein theinternal central passage has a first internal surface and a secondinternal surface spaced opposite to the first internal surface, thesuture includes a first tail having a first end and a second tail havinga second end, a first space is defined between one side of the rigidsupport and the first internal surface of the internal central passage,a second space is defined between an opposing side of the rigid supportand the second internal surface of the internal central passage, thefirst tail is located in the first space, and the second tail is locatedin the second space, wherein the suture strand follows a path beginningwith the first end of the first tail of the suture strand outside theanchor body, into the first space of the internal passage, around therigid support, back through the second space of the internal passage,and ending at the second end of the second tail of the suture strandoutside of the anchor body.
 27. The suture anchor assembly as recited inclaim 18 wherein the suture strand includes a first tail and a secondtail, and each of the first tail and the second tail is moveable in twodirections within the internal passage.
 28. A suture anchor assemblycomprising: an anchor body including a longitudinal axis, a lengthextending along the longitudinal axis, a proximal end, a distal end, theanchor body including an internal central passage extending from a firstopening at the proximal end of the anchor body, the internal centralpassage extending along the longitudinal axis, and the internal centralpassage extending through at least a portion of the length of the anchorbody, the anchor body including an external helical thread extendingalong the anchor body on a wall of the anchor body, the anchor bodyincluding a second opening and a third opening, the second openingdisposed distal of the first opening, and the third opening disposeddistal of the second opening and distal of a rigid support, and therigid support is disposed in a distal half of the anchor body, thedistal half of the anchor body including the distal end of the anchorbody, the second opening is proximate to the rigid support, and therigid support is attached to the wall, wherein the rigid supportincludes a first end portion and an opposing second end portion, andboth the first end portion and the second end portion are integral withthe anchor body, wherein the external helical thread extends 360 degreesaround the longitudinal axis for at least a portion of the length of theanchor body; and a suture strand disposed in the internal centralpassage, wherein the suture strand is supported by the rigid support,the suture strand extends out the proximal end of the anchor body, andthe suture strand is disposed in the first opening, the second openingand the third opening of the anchor body.